DRAFT. Module 4. Decontamination & Environmental Cleaning

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Shana Parsons
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1 Module 4. Decontamination & Environmental Cleaning

2 Learning Objectives 1. Define the 3 steps of decontamination 2. List and describe the process for cleaning and disinfecting 3. Discuss safe management of used linen 4. Discuss cleaning of reusable PPE

3 Why is cleaning and disinfection important? Germs can survive: on medical equipment (e.g. instruments) on surfaces (such as floors and tables) on clothing (including PPE) in body fluids (such as blood and vomit) If done correctly, cleaning & disinfection removes and kills most germs

4 What is Decontamination? Decontamination ensures an item or object is safe for reuse. There are three different steps: Cleaning physical removal of dirt and germs Disinfection kills almost all germs (i.e. 0.5% chlorine) Sterilization kills ALL germs using special type of equipment (i.e. autoclave)

5 Decontamination Process 1. CLEAN and remove visible waste using soap or detergent and water 2. DISINFECT using an effective disinfectant 3. WASH OFF any remaining disinfectant using clean water 4. Let air DRY or take outside to dry in the sun 5

(i.e. blood pressure cuffs) Always be sure to clean

6 Classification of Instruments Non-critical Any instrument that comes in contact with intact skin (i.e. blood pressure cuffs) Always be sure to clean between uses using towels/cloth soaked with disinfectant

7 Classification of Instruments (2) Semi-critical Any instrument that comes in contact with mucous membranes or non-intact skin (i.e. vaginal speculae) Always be sure to disinfect between uses, High level disinfection = Boiling Pot OR soaking in appropriate disinfectant

8 Classification of Instruments (3) Critical Any instrument that comes in contact with sterile tissue (i.e., delivery sets, surgical kits, catheters) Always be sure to sterilize critical items between uses (i.e. autoclave)

9 Risks During Cleaning and Disinfection Poor cleaning & disinfection can spread infection to: Patients Cleaners Visitors Staff You should always: Wear appropriate PPE based on risk of exposure Follow recommended steps exactly

10 Materials for Cleaning & Disinfection Appropriate PPE Often includes gown, rubber gloves, boots and face protection Soap and water Cloths and towels Bucket and mop Disinfectant General waste bin Medical waste bin

11 Principles of Cleaning and Disinfection

12 Why must we clean before disinfecting? All dirt and visible waste (e.g., body fluids) must first be removed/cleaned before using a disinfectant If we don t clean first, the disinfectant will not work

13 Principles of Cleaning The basic principles of cleaning and disinfecting apply to all patient care areas Where possible, dedicate cleaning supplies in higher risk areas (e.g., delivery, OR) Cleaning supplies for isolation should be kept and only used in isolation Always move from cleanest area to dirtiest area Always be sure to clean patient care equipment between each patient use 13

14 DO NOT Spray Spills NEVER spray disinfectant directly on body fluid spills It can create splashes or make the spill bigger Instead use towel or cloth to remove visible waste Once visible waste has been removed, clean area with disinfectant

15 Decontaminating Reusable Cleaning Supplies Any reusable item (cleaning towels, buckets, mops) should be appropriately disinfected after use: 1. Clean 2. Disinfect 3. Wash off using clean water 4. Dry When possible, use disposable towels. Throw towels away in a medical waste bin immediately after use

16 Recommended Cleaning Frequency Item Surfaces (floors, tables, chairs) Medical equipment (axillary thermometers) Plates and utensils Reusable PPE (aprons, boots) Linens and mattresses Frequency At least twice daily When visibly soiled After every patient After every patient After procedures After exiting an isolation area When visibly soiled After every patient When visibly soiled

17 Recommended Cleaning Frequency Place Screening area Isolation area Non-Patient care areas Latrines/toilets All areas Frequency At least twice daily After a patient with a suspected infectious disease At least once daily After every patient At least twice daily At least twice daily When visibly soiled Immediately following possible contamination with blood or bodily fluids

18 Cleaning in Isolation Areas Cleaners should be VERY careful when cleaning the isolation area Isolation areas should have their own cleaning supplies that are separate from clean patient care areas All waste from the isolation area is considered very contaminated and should be burned

19 Management of Used Linen

20 How to Manage Used Linen Use gown & gloves when handling used linen Scrape off excess blood and/or waste carefully into bucket Place linens into leak-proof bags or buckets labeled soiled for transport to laundry Linens used in isolation should be clearly labeled and kept separate from other used linens

21 How to Clean Used Linen When handling used laundry appropriate PPE should be worn Gloves Gown Face shield OR mask and goggles Use of a washing machine for cleaning used linens is preferred

22 SCENARIO

23 How to Clean Reusable PPE

24 How to Clean Reusable PPE 1. Collect PPE items (boots, rubber glove, aprons, goggles and face shields) from the PPE doffing area 2. Rinse any excess blood and/or waste carefully into waste bucket 3. Clean with soap and water to wash any soiled areas 4. Soak in appropriate disinfectant ( 5. Rinse with clean water 6. Hang to dry 7. Dump used disinfectant into latrine

25 One Bucket = One Job There are many buckets that are used for cleaning and removing waste A single bucket should not be used for more than one job because this can spread germs For example, do not use a bucket as a commode one day and the next day use it to store chlorine solution Buckets for specific purposes must be labeled and, if possible, color 25

26 Learning Objectives 1. Define the 3 steps of decontamination 2. List and describe the process for cleaning and disinfecting 3. Discuss safe management of used linen 4. Discuss cleaning of reusable PPE

27 Questions?

Jennings Street School

Jennings Street School Infection Prevention and Control and Protocols Rationale Following standard infection control precautions can minimise the risk of norovirus outbreaks caused by person-to-person transmission in any institution